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Table 2 Participant (pseudonym) characteristics and intervention engagement

From: Brief Engagement and Acceptance Coaching for Hospice Settings (the BEACHeS study): results from a Phase I study of acceptability and initial effectiveness in people with non-curative cancer

Participant

Clinical description

Engagement / session order

Intervention completers

 Elizabeth

58 year old single woman, with breast cancer. Elizabeth moved in with her sister during treatment, fearful of loss of independence and mobility. Her distress levels were low when she entered the intervention. At the time of referral she was undergoing palliative chemotherapy. She accessed orthopaedic services to discuss surgical options for her symptoms. Clinical data indicated that after a good chemotherapy response, Elizabeth was discharged from hospice community services 10 months after referral

Session 1: Module A

Session 2: Module B & C

Session 3: Module D

(3 week gap)

Session 4: Module E

Session 5: Module F

Interview: 7 weeks later

 James

81 year old widower, with oesophageal cancer. James had grown children living locally, with grandchildren. He was receiving palliative radiotherapy. James was moderately distressed, reviewing life meaning. He continued to have active engagement with a variety of hospice support services

Session 1: Module A

Session 2: Module B & D

Session 3: Module E

Session 4: Module C

Session 5: Module F

Interview 13 weeks later

 Graham

66 year old with oesophageal cancer and chronic obstructive pulmonary disorder. Graham was living with a supportive partner, and had children in other parts of the UK. He was not especially distressed but low in mood at times. Graham continued to access hospice day services

Session 1: Module A

Session 2: Module B & C

Session 3: Module D

Session 4: Module E

Session 5: Module F

Interview 2 weeks later

 Andrew

73 year old man with prostate cancer. He had a supportive wife and grown children. Andrew stopped conventional treatment when he was referred to hospice care. Overwhelmed by his diagnosis, and distressed, he accessed mainly emotional and psychological support. Other services used included occupational therapy

Session 1: Module A

Session 2: Module B & E

Session 3: Module D

Session 4: Module C

Withdrew 3 weeks later

 Michelle

46 year old woman with cervical cancer. She had a long history of interpersonal difficulties, relatively chaotic lifestyle, and previous episodes of psychological problems which were now stable. Michelle had completed palliative chemotherapy and sought emotional and benefits advice. She appeared avoidant of thinking of her illness

Session 1: Module A

Session 2: Module B & C

Session 3: Module D

Session 4: Module E

Session 5: Module F

(Over an extended 13 week period)

Withdrawn or deceased participants

 Sally

48 year old woman with lung cancer. Sally had children and young grandchildren, and was supported by her husband. At the time of entering the intervention, she was moderately distressed. Sally was receiving only palliative treatment and died 4 months after referral to the hospice. She had received visits from the hospice nursing service, but did not access any other hospice support or care services

Session 1: Module A

Session 2: Module B & C

Formally withdrew from study 11 weeks after this, and died two weeks later

 Mary

73 year old woman, with pancreatic cancer. She had a long history of psychological difficulties, although her mental health was currently stable. Mary was living alone, supported by her daughter. She appeared resilient throughout her time in the study. She was being cared for with ongoing pain and symptom management and in addition to hospice nurse visits, she accessed benefit support and diabetic nurse care. Mary died almost three months after her referral into hospice services

Session 1: Module A

Session 2: Module B & C

Withdrew from study the following week, and died five weeks later

 John

71 year old man with bladder cancer, who was undergoing palliative chemotherapy. He had increasing levels of pain and nausea and became socially withdrawn when told his cancer wasn’t curable. After two sessions he withdrew from the study because he decided to return to work. John was admitted to hospital five months after referral into hospice community services. He died in hospital a few weeks later

Session 1: Module A

Session 2: Module B & C

Withdrew from study five weeks later

 Daniel

69 year old man, with cancer of the digestive organs and peritoneum. Daniel was married, with grown children, and was well supported by his wife. Daniel became increasingly unwell over a short period time following hospitalisation for a suspected infection. He was receiving palliative treatment for pain, fatigue and agitation. Daniel died at home seven weeks after referral to hospice community services

Session 1: Module A

Withdrew from the study before Session 2

 Michael

72 year old man, diagnosed with colon cancer and liver metastases. Michael was living with his wife, and with children and grandchildren. Michael was relatively accepting, with low levels of distress throughout the intervention. He was being treated primarily for pain and accessed physiotherapy services through the hospices. Michael was admitted to inpatient care at the hospice following a hospital stay. He died in the hospice three months after his first referral

Sessions 1, 2 and 3 covered only Module A, and took place over a longer-than-specified period of time (7 weeks): patient died two weeks later