Background/Objective: In this study a theoretically driven model is presented of how gastrointestinal anxiety, behavioural response, symptom severity, quality of life and IBS acceptance interact to determine how people cope and respond in IBS. Method: Crosssectional data from 166 outpatients attending a motility disorders clinic was used to test a model of moderated serial mediation. Results: Gastrointestinal anxiety and behavioural response were found to serially mediate the relationship between symptom severity and quality of life; each step of this 'indirect effect' was significant at the p<.001 level. The strength of the mediatory effect was linearly related to IBS acceptance; a significant interaction was found between IBS acceptance as a moderator at the level of the indirect effect (-.0091, 95%CI =-.0163 to .0019). Conclusions: Findings suggest that the effect of multiple psychosocial variables in IBS experience and outcomes may be conditional on levels of IBS Acceptance. The theoretical and clinical implications of these findings are discussed.
The Living Well with Neurological Conditions Acceptance and Commitment Therapy (ACT) group workshops (Hill et al., 2017a) aim to assist outpatients with neurological conditions to cultivate greater psychological flexibility towards a more valued life. This service evaluation analyses aggregated clinical outcome data from seven Living Well interventions (2016 – 2019, N=39). We report improved self-reported outcomes in psychological flexibility (AAQ-II), value congruent-living (VQ), trait mindfulness (FFMQ) and overall psychological distress (CORE-10) between the first and final sessions. The stringent criterion for clinically significant reliable change in overall psychological distress was attained for 30.8 per cent of cases. These promising findings highlight the growing need for further research into ACT-based group interventions for individuals adjusting to the impact of neurological conditions.
This article has two aims. Firstly, to describe how UKROC tools (which are mandated for use in every specialist inpatient neurorehabilitation unit in England: Standard Contract for Specialist Rehabilitation, NHS England, 2013) can be used to assess the level of need for neuropsychological intervention. We identify patients with a neuropsychological need using items from the UKROC data set. The methods and rationale for item selection is outlined here. This could be replicated by neuropsychologists locally to plan adequate neuropsychology services or highlight unmet need. Secondly, we have used these methods to assess the need for neuropsychological services across England over the last five years, using national UKROC data (N=26,484 episodes of care). The results indicate 62–75 per cent per cent of case episodes in specialist neurorehabilitation units in England, between 2014 and 2019, could be classified as having a neuropsychological need. We conclude this provides evidence to suggest neuropsychologists should be adequately funded to provide a service to every specialist neurorehabilitation unit in the UK and should be considered an essential part of any specialist inpatient neurorehabilitation team. We discuss the importance of considering this level of need at the national policy level.
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