Work

Development of ACT+: A Novel, Person‐Centred Psychological Intervention Based on Acceptance and Commitment Therapy (ACT) to Improve Quality of Life in Patients Living With and Beyond Cancer

Year: 2025

Type: article

Abstract: INTRODUCTION: The need to improve the quality of life (QoL) and well-being of people living with and beyond cancer is well recognised. SURECAN (SUrvivors' Rehabilitation Evaluation after CANcer) is a multiphase study developing and evaluating a psychological intervention based on acceptance and commitment therapy (ACT) for people who have completed hospital-based treatment for cancer but have low QoL. We describe the process by which we iteratively developed and refined ACT+, an intervention in which ACT is integrated with options to support exercise and work. METHODS: ACT+ development was guided by the theory of ACT while Normalisation Process Theory (NPT) was used as a sensitising tool at all stages. Evidence from several strands of research comprising a qualitative meta-synthesis, a qualitative study with stakeholders and pre-pilot testing was brought together to refine ACT+. Insights from patient and public involvement (PPI) consultations supported the development and refinement of ACT+ resources throughout. RESULTS: The qualitative study with stakeholders shed light on the 'real world' contexts in which the ACT+ intervention would be offered and accessed, as well as the appeal of ACT+ as a therapy for people living with and beyond cancer. People who had treatment for cancer (n = 31) and healthcare professionals (n = 16) provided overall support for the intervention. Subsequent pre-pilot testing of the intervention and qualitative work with cancer patients (n = 6) and therapists (n = 7) led to further refinements. Evidence collected from all strands of research and PPI was integrated in an iterative way to produce an intervention that was acceptable to all. CONCLUSION: We adopted an iterative and evidence-based approach to the development of the ACT+ intervention, which was acceptable to patients and healthcare professionals. Future work will examine the effectiveness of ACT+. PATIENT AND PUBLIC ENGAGEMENT: This intervention was developed and refined with substantial involvement from the study's patient and public involvement group and others accessed via community/patient groups to discuss and gain feedback on patient-facing materials. For example, the ACT+ participant handbook underwent four consultation rounds with patient representatives, including a consultation specifically focused on its cultural acceptability. Therefore, emerging insights from PPI were also used to optimise ACT+ components and delivery. Their input was integrated throughout all three strands of the research.

Source: Health Expectations

DOI: 10.1111/hex.70237