Self-help ACT for wellbeing among cardiac patients v1
Research type
Research Study
Full title
Acceptance and Commitment therapy (ACT) for wellbeing among cardiac patients: a self-help intervention.
IRAS ID
323930
Contact name
David Dawson
Contact email
Sponsor organisation
University of Lincoln
Duration of Study in the UK
0 years, 9 months, 25 days
Research summary
Summary of Research
The study aims to examine the effectiveness of a digital self-help psychological intervention based on Acceptance and Commitment Therapy (ACT) in improving wellbeing among cardiac patients experiencing psychological distress. If effective in improving wellbeing in this population, the study will aim to determine whether changes seen are due to ACT processes. Participants will be recruited through Nottingham University Hospital’s (NUH) cardiac rehabilitation program. Participants will receive a weekly email containing ACT based exercises, and will complete online questionnaires at designated intervals throughout the study, to measure their levels of distress, psychological flexibility and self-compassion levels. Participants will have the opportunity to attend a weekly group meeting, held on MS Teams, and will be able to send questions to the researcher in advance, so that these can be answered in the meeting, allowing privacy and anonymity.
Summary of Results
Background Cardiac events include heart attacks (when there is a loss of blood supply to the heart) and cardiac arrests (when problems with the heart’s electrical system stops blood from being pumped around the body). Following a cardiac event some people can experience psychological and emotional difficulties (called cardiac distress). If left untreated, this distress can affect a person’s ability to cope with their condition and treatment, which can impact their recovery and wellbeing, and lead to further risks.
Research suggests that psychological support can help cardiac patients who experience distress, but it is not clear which type of therapy is best suited to them. Acceptance and Commitment Therapy (ACT) has shown some promise, but more research about how this might work for cardiac patients is needed. There is a lack of psychological support in UK health cardiac rehabilitation services due to limited resources and pressures, but online psychological programmes could increase accessibility for patients.
Research aim
To examine the effectiveness of an online self-help ACT programme to improve wellbeing among cardiac patients.Method
Participants were recruited from a hospital cardiac rehabilitation service and through online cardiac groups. Five participants completed a programme of six weekly self-help ACT workbooks. The ACT workbooks had been used in previous research, and were adapted for the study in consultation with a psychologist with experience of using ACT with cardiac patients, and with a cardiac patient with lived experience of mental health difficulties.Participants completed weekly questionnaires measuring their psychological flexibility (a person’s ability to be open to all feelings, to be present in the moment, and to choose actions in line with their values). We also measured levels of wellbeing, anxiety, and depression through questionnaires. We graphed each participant’s scores before, during, and after the ACT programme. We analysed these to see whether there were changes. Participants also provided written feedback about the programme and their experiences afterwards.
What the research discovered
We thought that increases in psychological flexibility through engagement in the ACT workbooks would increase wellbeing. We did not find clear evidence of this, but we did see significant increases in wellbeing in two participants, and significant increases in psychological flexibility in two different participants.
We also saw significant improvements in anxiety and depression scores for four participants, but because we did not detect changes in psychological flexibility, we think this improvement was more likely due to factors outside of the study, such as support from family. Some participants reported improved coping skills that they believed were related to the ACT workbooks, but some thought these were due to other factors. Some participants found the workbooks helpful and enjoyable, but some found them harder to engage with.Recommendations
Further research and development of the programme is justified. Recommendations include: using an app based programme with shorter sessions; increasing service user involvement in development; increasing ACT sessions from six to eight; offering more guidance from a therapist, and meeting with participants before they start the study.How the findings will be shared?
A report will be shared with interested participants of the study, cardiac rehabilitation staff, and online group contacts involved in advertising the study. A journal paper will be submitted to a peer reviewed Health Psychology journal.
REC name
West of Scotland REC 4
REC reference
23/WS/0092
Date of REC Opinion
21 Jul 2023
REC opinion
Further Information Favourable Opinion