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The Relationship Between Psychological Flexibility, Value-Based Living and Emotional Well-Being in People Affected by Cancer

Background: Receiving a cancer diagnosis can have detrimental effects on an individual's psychological flexibility (ability to adapt constructively to reality), emotional well-being and ability to live aligned with personal values, for example, in relationships and work. Higher levels of psychological flexibility and emotional well-being are associated with better quality of life and lower psychological cancer-related distress. In turn, value-based living is positively associated with psychological flexibility and emotional well-being. There is, however, limited research specifically exploring the relationship between value-based living and emotional well-being within individuals affected by cancer. Maggie's Centres ( www.maggiescentres.org ) offer an innovative, multidisciplinary model of holistic supportive cancer care, widely regarded as an exemplar of best practice in cancer rehabilitation and supported self-management. In 2017 Maggie's received 249,247 visits across the network of Centres in the UK, Hong Kong and Tokyo. Principles of ACT (acceptance and commitment therapy) are incorporated within the program of individual support, psychoeducational courses and groups to help people maximize their quality of life. Aim: To explore the associations between psychological flexibility, value-based living and emotional well-being in individuals affected by cancer. Methods: Sixty-five people, affected by a cancer diagnosis personally or in a family member, were recruited from four UK Maggie's Centres. Participants completed standardized questionnaires measuring psychological flexibility, valued-based living and emotional well-being. Results: Moderate positive associations were found between emotional well-being and psychological flexibility (r=.4750), as well as emotional well-being and valued-living (r=.37983). Psychological flexibility was also positively associated with valued living (r=.443474). Multiple regression analysis revealed a significant model (F(5,54)=9.35, P < .001), accounting for 41.4% of the variance in emotional well-being (adjusted R2 = .414). Both psychological flexibility (b=.357, P = .002) and valued-living (b=.337, P = .004) were predictors of emotional well-being across all ages, gender and time since diagnosis. Conclusion: The study provides support for the positive associations between psychological flexibility, valued-living and emotional well-being and indicates that psychological flexibility and valued-living may be predictors of emotional well-being. This was a small observational study, so conclusions about causation or change over time cannot be made. Longitudinal intervention studies need to explore the potential impact valued-living and psychological flexibility may have on emotional well-being in those affected by cancer, and so contribute to understanding the potential importance of encouraging valued-living as a therapeutic tool within cancer care.