Contains Video1Improving Psychological Adjustment Among Late-Stage Ovarian Cancer Patients: Examining the Role of Avoidance in Treatment
Highlights
► We examined the efficacy of ACT in treating distress among patients with advanced cancer. ► ACT was at least as effective as TAU on all measures of psychological distress. ► Avoidance plays a significant mediating role in treatment outcomes.
Section snippets
Participants
Fifty-seven women with Stage III or IV ovarian cancer were invited to participate in the study. Ten declined to participate, either citing travel as an issue, as they were receiving their primary medical treatment elsewhere (n = 6), or a lack of interest (n = 4). Of the 47 participants, 31 completed the full treatment protocol and data collection. Twelve participants passed away during the course of the intervention protocol, and 4 transferred to home-based hospice care and were unable to continue.
Outcome Analytic Strategy
Hierarchical linear modeling (HLM) was the primary analytic method used to investigate outcomes and changes in processes using an intent-to-treat sample (Raudenbush and Bryk, 2001a, Raudenbush and Bryk, 2001b). The HLM analyses were conducted assuming a random intercept and slope, and allowing them to be correlated. Simpler models with uncorrelated slopes and intercepts and then a random intercept only model were tested and used if they were not significantly different from the more complex
Discussion
This study is one of few to attempt to evaluate and compare psychological interventions in the reduction of distress among women with late-stage ovarian cancer, and the only one to use an ACT treatment model. Our hypotheses were partially supported by the data. The ACT treatment group showed greater decreases in psychological distress compared to the TAU group, as well as higher reports of quality of life at the end of treatment. This change in quality of life is particularly notable, given
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Video patients/clients are portrayed by actors.