A pilot study of the relationship between acceptance and rehabilitation outcomes in patients receiving specialist palliative care.

Rehabilitation in palliative care aims to maximize physical functioning, provide supportive care and improve quality of life. For some patients adapting to illness and attempting rehabilitation can be hindered by negative thoughts and feelings. It may be helpful to develop supportive strategies to enable patients to manage negative emotions more effectively. Acceptance Commitment Therapy (ACT) is a form of talking psycho-therapy that relies on developing an individual’s psychological flexibility. It encourages patients to acknowledge, accept and manage unpleasant stimuli and negative emotions and may lead to improved coping strategies and less psychological distress. A measure of acceptance, the Acceptance and Action Questionnaire II (AAQ-II), has been developed for use in empirical studies of ACT. To explore the relationship between acceptance and rehabilitation outcomes. A consecutive sample of patients (cancer and non-cancer) attending a specialist palliative care day therapy unit for rehabilitation completed (i) AAQ–II to measure acceptance; (ii) Kessler-10 to measure psychological status. Physical function was assessed by (i) timed 2 minute walking test; (ii) one minute sit to stand test. Correlation statistics and multivariable regression analyses will be used to determine the strength of relationship between acceptance and psychological status and physical function. To achieve 90% power, a recruitment target of 100 participants was set. Ninety two patients have been recruited and our current sample predominantly consists of white females with a cancer diagnosis, mean age 64 years. We expect to achieve our recruitment target by December 2009 and results of the analysis will be available in early 2010. The findings will inform the rationale for an exploratory randomised controlled trial of an ACT intervention for this patient group.