The effects of acceptance and commitment therapy (ACT) on psychological and physical outcomes among cancer patients and survivors: An umbrella review

IF 3.4 3区 心理学 Q1 PSYCHOLOGY, CLINICAL Journal of Contextual Behavioral Science Pub Date : 2024-07-01 DOI:10.1016/j.jcbs.2024.100810
Christina Sauer , Alexander Haussmann , Gregor Weissflog
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Abstract

Background

Acceptance and Commitment Therapy (ACT) is a promising approach in psycho-oncology that has led to an increasing number of studies and reviews. This systematic umbrella review provides a comprehensive overview of the results of existing systematic reviews and meta-analyses to investigate the trans-symptomatic (i.e., psychological and physical symptoms) efficacy of ACT in the context of cancer. The study addresses both physical and psychological outcomes, aiming to identify existing research gaps and delineate potential focal points for future studies exploring the application of ACT in psycho-oncological settings.

Methods

A systematic literature search was conducted in Pubmed, Ebsco Host Academic Search Complete (incl. APA PsycInfo), Web of Science, Cochrane Library, website of the Association of Contextual Behavioral Science (ACBS), and Prospero. To be included, studies had to meet the following criteria: 1) be a systematic review and/or meta-analysis focusing on ACT and its impact on psychological and physical outcomes in cancer patients or survivors; 2) include only patients with oncological conditions; 3) be published in English. The quality of the reviews and meta-analyses was assessed using the AMSTAR 2 criteria.

Results

We included eight systematic reviews and meta-analyses in our synthesis. Results of the reviews and meta-analyses indicate that ACT interventions increase the health-related quality of life (HRQoL) and psychological flexibility, and reduce depression, anxiety, and psychological distress in cancer patients and survivors. The best evidence exists regarding psychological distress and HRQoL. The efficacy of these interventions concerning other psychological outcome measures (e.g., fear of progression/recurrence, hope) and biological parameters has not yet been well investigated. Moderator analyses revealed larger effects for younger patients, individuals from Eastern countries (Iran, China), and after longer intervention durations. Results suggest potential differential effects based on the cancer stage. According to the AMSTAR 2 criteria, the quality of the included reviews was low or critically low.

Conclusion

Recent meta-analyses and reviews suggests that ACT interventions are an effective and evidence-based treatment for increasing HRQoL and reducing psychological distress in patients with cancer. However, the results should be interpreted with caution, as the quality of the included reviews was generally low. Our synthesis highlights the need for more high-quality randomized controlled trials, reviews, meta-analyses, and mediator analyses in this research area.

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接受与承诺疗法(ACT)对癌症患者和幸存者心理和生理结果的影响:综述
接纳与承诺疗法(ACT)是一种很有前景的肿瘤心理治疗方法,它引发了越来越多的研究和综述。本系统性综述全面概述了现有系统性综述和荟萃分析的结果,以研究 ACT 在癌症方面的疗效(即心理和身体症状)。本研究同时探讨了生理和心理结果,旨在找出现有研究的不足之处,并为今后探讨 ACT 在肿瘤心理环境中应用的研究划定潜在的重点。我们在 Pubmed、Ebsco Host Academic Search Complete(包括 APA PsycInfo)、Web of Science、Cochrane Library、情境行为科学协会(ACBS)网站和 Prospero 中进行了系统的文献检索。纳入的研究必须符合以下标准:1)系统综述和/或荟萃分析侧重于 ACT 及其对癌症患者或幸存者心理和生理结果的影响;2)仅包括肿瘤患者;3)以英语发表。综述和荟萃分析的质量采用 AMSTAR 2 标准进行评估。我们将 8 篇系统综述和荟萃分析纳入了我们的综述。综述和荟萃分析的结果表明,ACT 干预疗法可以提高癌症患者和幸存者的健康相关生活质量(HRQoL)和心理灵活性,减少抑郁、焦虑和心理困扰。心理困扰和 HRQoL 方面的证据最为充分。这些干预措施对其他心理结果测量(如对病情恶化/复发的恐惧、希望)和生物参数的疗效尚未得到很好的研究。主持人分析显示,年轻患者、来自东方国家(伊朗、中国)的患者以及干预持续时间较长的患者的效果更大。结果表明,癌症分期可能会产生不同的影响。根据 AMSTAR 2 标准,纳入的综述质量较低或极低。最近的荟萃分析和综述表明,ACT 干预是一种有效的循证治疗方法,可提高癌症患者的 HRQoL 并减少心理困扰。然而,由于纳入的综述质量普遍较低,因此在解释这些结果时应谨慎。我们的综述强调,在这一研究领域需要更多高质量的随机对照试验、综述、荟萃分析和中介分析。
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来源期刊
CiteScore
8.50
自引率
18.00%
发文量
82
审稿时长
61 days
期刊介绍: The Journal of Contextual Behavioral Science is the official journal of the Association for Contextual Behavioral Science (ACBS). Contextual Behavioral Science is a systematic and pragmatic approach to the understanding of behavior, the solution of human problems, and the promotion of human growth and development. Contextual Behavioral Science uses functional principles and theories to analyze and modify action embedded in its historical and situational context. The goal is to predict and influence behavior, with precision, scope, and depth, across all behavioral domains and all levels of analysis, so as to help create a behavioral science that is more adequate to the challenge of the human condition.
期刊最新文献
Feasibility of a brief, remote self-compassion intervention for employed mothers Exploring the interconnectedness of depression, anxiety, diabetes distress, and related psychosocial factors in adults with type 2 diabetes: A network analysis Effects of a randomized controlled trial of mobile app-based Acceptance and Commitment Therapy on depressive symptoms and process variables in college students - Focusing on the mediating effects of acceptance and cognitive defusion- Changes in university students’ behaviour and study burnout risk during ACT-based online course intervention: A mixed methods study Third wave interventions for adolescents with mental health disorders: A systematic review with meta-analysis
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