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Symptom experiences in advanced cancer: Relationships to acceptance and commitment therapy constructs
Catherine E Mosher1, Ellen Krueger1, Ekin Secinti1
1Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA.
Psycho-Oncology
|April 27, 2021
Summary
Acceptance and Commitment Therapy (ACT) constructs are linked to symptom subgroups in advanced cancer patients. Higher ACT engagement correlates with better symptom management and functioning.
Area of Science:
- Psychology
- Oncology
- Behavioral Medicine
Background:
- Advanced cancer patients often experience heterogeneous symptom profiles.
- Understanding the relationship between psychological factors and symptom clusters is crucial for effective patient care.
Purpose of the Study:
- To examine the associations between Acceptance and Commitment Therapy (ACT) constructs and distinct symptom-based subgroups in patients with advanced cancer.
- To identify psychological variables that differentiate patient profiles based on symptom severity and type.
Main Methods:
- A cross-sectional study involving 201 patients with advanced breast, gastrointestinal, lung, and prostate cancer.
- Questionnaires assessed five common symptoms and key ACT variables including psychological inflexibility, cognitive fusion, values obstruction/progress, acceptance, mindfulness, and activity engagement.
- Latent profile analysis was used to identify patient subgroups based on symptom presentation.
Main Results:
- Three distinct patient profiles emerged: minimal symptoms, mild sleep/fatigue issues, and moderate fatigue with mild sleep, anxiety, and depressive symptoms.
- Lower psychological inflexibility, cognitive fusion, and values obstruction were linked to better symptom profiles (Classes 1 & 2 vs. Class 3).
- Greater values progress, acceptance, mindfulness, and activity engagement were associated with the best symptom profile (Class 1 vs. Class 3), while mindfulness and activity engagement also predicted better outcomes in Class 2 vs. Class 3.
Conclusions:
- Advanced cancer patients exhibit diverse symptom patterns, with even mild symptoms correlating with reduced engagement in meaningful activities and lower acceptance.
- Findings support the ACT model, suggesting its potential utility in addressing symptom interference with functioning in advanced cancer care.
- Further research and clinical trials are warranted to test ACT interventions for this population.
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