Green Sophie M C, Hall Louise H, Ellison Rachel, Clark Jane, Wilkes Hollie, Hartley Suzanne, Naik Jay, Buckley Sarah, Hirst Charlotte, Hartup Sue, Neal Richard D, Velikova Galina, Farrin Amanda, Collinson Michelle, Graham Christopher D, Smith Samuel G
Leeds Institute of Health Science, University of Leeds, Leeds, UK.
Department of Health Sciences, University of York, York, UK.
Br J Health Psychol. 2025 May;30(2):e12802. doi: 10.1111/bjhp.12802.
Adjuvant endocrine therapy (AET) reduces breast cancer recurrence, but side effects and distress impact adherence. We co-designed an Acceptance and Commitment Therapy (ACT) intervention to support medication decision-making and quality of life in women prescribed AET (ACTION). In a qualitative process evaluation nested in the pilot trial, we aimed to elicit participant experiences of receipt and therapists experience of delivery of ACTION to enhance our understanding of acceptability.
Remote semi-structured interviews were conducted with women with breast cancer who received ACTION (n = 20) and trial therapists (n = 3).
Interviews were guided by the Theoretical Framework of Acceptability (TFA). Rapid Assessment Procedure (RAP) sheets were completed after each interview to map responses onto TFA constructs, and sections of interviews were selectively transcribed. Individual RAP sheets were collated to identify key findings.
ACTION was generally liked, in particular, the group format (affective attitude). Participants and therapists felt ACTION was low effort, but therapists acknowledged the burden associated with trial procedures (burden). Participants generally felt able to engage with ACTION, and therapists felt they were able to deliver it (self-efficacy). The perceived effectiveness of ACTION on well-being was good, but was mixed for impact on treatment adherence (perceived effectiveness). Participants and therapists understood the aims of ACTION (coherence), and ACTION generally aligned with therapists' values (ethicality). Therapists questioned who would be most appropriate to deliver ACTION (opportunity costs).
ACTION was acceptable to women with breast cancer and trial therapists. Rapid qualitative analysis can facilitate efficient process evaluations in time- and resource-limited contexts.
辅助内分泌治疗（AET）可降低乳腺癌复发率，但副作用和痛苦会影响治疗依从性。我们共同设计了一种接受与承诺疗法（ACT）干预措施，以支持接受AET治疗的女性（ACTION研究）做出用药决策并提高生活质量。在一项嵌套于试点试验中的定性过程评估中，我们旨在了解参与者接受该干预措施的体验以及治疗师实施该干预措施的体验，以增进我们对其可接受性的理解。
对接受ACTION干预措施的乳腺癌女性患者（n = 20）和试验治疗师（n = 3）进行了远程半结构化访谈。
访谈以可接受性理论框架（TFA）为指导。每次访谈后完成快速评估程序（RAP）表格，将回答映射到TFA结构上，并对访谈部分进行选择性转录。整理个人RAP表格以确定关键发现。
参与者总体上喜欢ACTION干预措施，尤其是小组形式（情感态度）。参与者和治疗师认为ACTION干预措施所需精力较少，但治疗师承认试验程序带来的负担（负担）。参与者总体上感觉能够参与ACTION干预措施，治疗师感觉他们能够实施该措施（自我效能感）。ACTION干预措施对幸福感的感知效果良好，但对治疗依从性的影响则好坏参半（感知效果）。参与者和治疗师理解ACTION干预措施的目标（连贯性），并且ACTION干预措施总体上与治疗师的价值观一致（道德性）。治疗师质疑谁最适合实施ACTION干预措施（机会成本）。
ACTION干预措施对于乳腺癌女性患者和试验治疗师来说是可接受的。快速定性分析可以在时间和资源有限的情况下促进高效的过程评估。
