Abstract
Background Palliative care workers commonly experience workplace stress and distress. General stressors include unmanageable workloads and staff shortages. Stressors specific to palliative care include regular exposure to death, loss and grief. The COVID pandemic exacerbated exhaustion and burnout across the healthcare system, including for those providing palliative care. Evidence based psychological support interventions, tailored to the needs and context of palliative care workers, are needed. Acceptance and Commitment Therapy (ACT) is an established form of cognitive behavioural therapy which uses behavioural psychology, values, acceptance, and mindfulness techniques to improve mental health and wellbeing. ACT is effective in improving workplace wellbeing in many occupational settings. Our study examines the acceptability and feasibility of an online ACT-based intervention to improve mental health and wellbeing in staff caring for people with an advanced progressive illness. Methods A single-arm feasibility trial. We will seek to recruit 30 participants to take part in an 8- week online ACT-based intervention, consisting of three synchronous facilitated group sessions and five asynchronous self-directed learning modules. We will use convergent mixed methods to evaluate the feasibility of the intervention. Quantitative feasibility outcomes will include participant recruitment and retention rates, alongside completion rates of measures assessing stress, quality of life, wellbeing, and psychological flexibility. Focus groups and interviews will explore participant perspectives on the intervention. We will run a stakeholder workshop to further refine the intervention and identify outcomes for use in a future evaluation. Results We will describe participant perspectives on intervention acceptability, format, content, and perceived impact alongside rates of intervention recruitment, retention, and outcome measure completion. Conclusion We will show whether a brief, online ACT intervention is acceptable to, and feasible for palliative care workers. Findings will be used to further refine the intervention and provide essential information on outcome assessment prior to a full-scale evaluation.
Highlights
Healthcare professionals working in palliative care settings commonly experience stress and distress1–3
We propose an Acceptance and Commitment Therapy (ACT) based psychological intervention to improve wellbeing, stress, and distress in palliative care workers
Drawing on evidence of effectiveness in other occupational and healthcare settings16,17,21–23, we propose that an ACT-based psychological intervention has strong potential to improve mental health and wellbeing in palliative care workers
Summary
Design A single-arm feasibility trial of a brief ACT-based intervention for staff providing palliative care for terminally ill adults. Participant recruitment Members of the research team will discuss the proposed study with service managers and clinical leads across Marie Curie Scotland. To facilitate engagement participants will be encouraged to share their experiences of the intervention, and any questions they might have via the online chat function (within MS Teams). If a participant does report feeling heightened stress or distress, the course leader, a Clinical Psychologist, will discuss immediate concerns with them, and will signpost them to additional resources and support as appropriate This may include: i) the Marie Curie Employee Assistance Programme (EAP) which includes practical information and emotional support guidance as well as access to trained counsellors; ii) to their line manager or HR manager if appropriate; iii) to a Marie Curie hospice-based Clinical Psychologist. The number of participants who take part in post-intervention focus groups or interviews (target is 50–75% of those recruited given that focus groups will be run during work time and some participants will be unable to take part due to work schedules and annual leave)
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