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评估交互式接受与承诺疗法(ACT)工作坊在英国为接受过培训的癌症患者治疗师提供的效果:混合方法研究。

Evaluating an interactive acceptance and commitment therapy (ACT) workshop delivered to trained therapists working with cancer patients in the United Kingdom: a mixed methods approach.

机构信息

Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

Mind-Growth Mastery, Epsom, Surrey, KT19 0AA, England.

出版信息

BMC Cancer. 2022 Jun 13;22(1):651. doi: 10.1186/s12885-022-09745-4.

Abstract

BACKGROUND

SURECAN (SUrvivors' Rehabilitation Evaluation after CANcer) is a multi-phase study developing and evaluating an Acceptance and Commitment Therapy (ACT) intervention integrated with exercise and work when highly valued (thus we called the intervention ACT+), for people who have completed treatment for cancer but who have low quality of life. We developed a training programme for therapists working in different psychological services to be delivered over 2-3 days. Our aim was to evaluate the extent to which the training could improve therapists' knowledge and confidence to deliver ACT+ to cancer patients in a trial setting.

METHODS

Three interactive workshops were delivered to 29 therapists from three clinical settings in London and in Sheffield. A mixed-methods approach was used. Questionnaires were designed to assess knowledge and confidence in using ACT+ with people who have low quality of life after cancer treatment. They were self-administered immediately prior to and after each workshop. Open text-based questions were used to elicit feedback about the workshops alongside a satisfaction scale. Semi-structured interviews were conducted with a purposive sample of therapists (n = 12) to explore their views about the training more deeply, and how it might be optimised.

RESULTS

Quantitative analysis showed that knowledge of ACT, as well as confidence in using the ACT+ intervention in this setting increased significantly after training (28.6 and 33.5% increase in the median score respectively). Qualitative analysis indicated that most therapists were satisfied with the content and structure of the programme, valued the rich resources provided and enjoyed the practice-based approach. Potential barriers/facilitators to participation in the trial and to the successful implementation of ACT+ were identified. For some therapists, delivering a manualised intervention, as well as supporting exercise- and work-related goals as non-specialists was seen as challenging. At the same time, therapists valued the opportunity to be involved in research, whilst training in a new therapy model.

CONCLUSIONS

Training can effectively improve the knowledge and confidence of therapists from different clinical backgrounds to deliver a modified ACT intervention to cancer patients in a trial setting.

摘要

背景

SURECAN(癌症康复后患者的康复评估)是一项多阶段研究,开发并评估了一种接受和承诺疗法(ACT)干预措施,该干预措施与运动和高价值的工作相结合(因此我们称之为 ACT+),适用于已完成癌症治疗但生活质量较低的人群。我们为在不同心理服务机构工作的治疗师开发了一个培训计划,该计划将在 2-3 天内完成。我们的目的是评估培训在多大程度上可以提高治疗师在试验环境中向癌症患者提供 ACT+的知识和信心。

方法

来自伦敦和谢菲尔德三个临床地点的 29 名治疗师参加了三个互动研讨会。采用混合方法。问卷旨在评估治疗师在癌症治疗后生活质量较低的人群中使用 ACT+的知识和信心。他们在每个研讨会之前和之后都进行了自我管理。使用基于文本的开放式问题来征求对研讨会的反馈意见,同时使用满意度量表。对治疗师进行了有针对性的半结构式访谈(n=12),以更深入地探讨他们对培训的看法,以及如何优化培训。

结果

定量分析表明,ACT 的知识以及在这种情况下使用 ACT+干预的信心在培训后显著增加(中位数分数分别增加了 28.6%和 33.5%)。定性分析表明,大多数治疗师对课程的内容和结构感到满意,重视提供的丰富资源,并喜欢实践为基础的方法。确定了参与试验和成功实施 ACT+的潜在障碍/促进因素。对于一些治疗师来说,作为非专家提供一种规范化的干预措施,以及支持运动和工作相关目标被视为具有挑战性。与此同时,治疗师重视参与研究的机会,同时接受新的治疗模式培训。

结论

培训可以有效地提高来自不同临床背景的治疗师的知识和信心,以便在试验环境中向癌症患者提供修改后的 ACT 干预措施。

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Cancer Statistics, 2021.癌症统计数据,2021.
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